دورية أكاديمية

Analysis of two cases of patent ductus arteriosus ligation in preterm identical twins and literature review.

التفاصيل البيبلوغرافية
العنوان: Analysis of two cases of patent ductus arteriosus ligation in preterm identical twins and literature review.
المؤلفون: Xiang Cao, Xiao-Ding Chen, Ling Yang, Ren-Wei Chen, Yan Li, Ze-Lai Mo, Wei Xiang
المصدر: Journal of Hainan Medical University; Sep2020, Vol. 26 Issue 17, p57-60, 4p
مصطلحات موضوعية: HEMODYNAMICS, NEONATOLOGY, ECHOCARDIOGRAPHY, PHARMACOLOGY, NEWBORN infants
مستخلص: Objective: To investigate the timing and effect of surgical ligation in the treatment of patent ductus arteriosus(PDA) in preterm identical twins. Methods: Retrospective analysis was made on the treatment of 2 cases of preterm twins with hemodynamic significant PDA(hsPDA) with corresponding clinical manifestation in our neonatology department, and literatures of PDA ligation for preterm twins were retrieved. Results: These 2 cases were naturally conceived monochorionic diamniotic twins, with gestational age 30+2 weeks, birth weight was 1510g and 780g for larger twin and smaller twin, with birth weight discordance 48.3%.They both developed hsPDA with corresponding clinical manifestation, series Echocardiography showed evidence of left to right shunting and cardiac insufficiency which were left atrial and ventricular enlargement, large PDA(2.8~3.5mm), failed two courses of ibuprofen, N-terminal pro-brain natriuretic peptide level increased significantly, finally received surgical ligation with significant clinical improvement and no related complications.12 cases were found from literature search, including our 2 cases, of these,2 died,9 were cured and 1 improved significantly. Among 6 cases whose detailed information were available,4 infants were identical twins,2 unknown. Conclusions: Preterm identical twins have the same genetic basis, the possibility of PDA ligation for both the larger twin and smaller twin should be alerted if the gestaional age is small and birth weight discordance is above 30%.If preterm twins have hsPDA who may fail ibuprofen treatment, surgical ligation should be considered early, and it is safe and effective. [ABSTRACT FROM AUTHOR]
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